Neal Petersen, TLMHC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

091327 Issued in IA

Practice address

1310 Solar Dr
Waterloo, IA 50701-2463

Phone

(319) 232-2086

NPI assigned

Aug 31, 2018

Last updated

Aug 31, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment Care Compare group NPD
• New Directions Counseling Services, PLLC.

  • Community/Behavioral Health Agency
  • Waterloo, IA
  • NPI 1255569331
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1235611716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 SOLAR DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507012463",
            "telephone_number": "319-232-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 SOLAR DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507012463",
            "telephone_number": "319-232-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "NEAL",
        "credential": "TLMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IA",
            "license": "091327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peoples Community Health Clinic, Inc (Success Street - East High School)
• Peoples Community Health Clinic, Inc.
• Peoples Community Health Clinic, Inc. (Peoples Clinic Pharmacy)
• Michael F. Peters, M.D.
• James Robert Petersen, RPH
• Adaline Lee Peterson, A.R.N.P.
• Benjamin Robert Peterson, DDS
• Jacob John Peterson, PHARMD
• Jaden Peterson
• Taylor Noelle Peterson, LMSW

• Professional Counselor in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Professional Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.